Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In theory, once a provider achieves Meaningful Use and picks up their first check, one might think that they’re on board and ready to power through the program. Well, think again.

According to a piece published in HIT Consultant, 17 percent of providers who got an $18,000 EMR check in 2011 didn’t get the second $12,000 incentive payout in 2012. The stats come from a recently published analysis of the federal April EMR attestation data crunched by Wells Fargo.

What that means, in real terms, is that 17 percent of providers were able to demonstrate MU for the 90 days required in 2011 but couldn’t keep things up for the full year required for to get the second check, notes Evan Steele, CEO of EMR firm SRSsoft, who authored the article.

You’d think that providers could have demonstrated a year’s compliance, given that after 90 days they already had the needed workflows in place to support those requirements, but for nearly 20 percent of providers, it seems that simply wasn’t the case, Steele says. And this is very bad news, he suggests:

A 17% loss rate in any business is wholly unacceptable, and this failure does not portend well for the future of the EHR Incentive Program. If $12,000 proved to be insufficient motivation for physicians with meaningful use experience to meet the relatively low requirements of Stage 1 on an ongoing basis, it would be foolish to expect physicians to muster the wherewithal to meet the increasingly demanding requirements of Stage 2. The incentive for a year’s performance at that point will be a mere $4,000.

Thinking that perhaps the 17 percent dropoff trend will correct itself as time passes? Probably not. As Steele points out, another survey recently found that 14 percent of physicians who attested to Stage 1 already say that they don’t intent to attest to Stage 2.

As Steele sees it, this is evidence that we need to simplify Meaningful Use rather than making it increasingly complex, while focusing on interoperability across the entire healthcare system. In his view, if we don’t “the entire program will go down the drain.”

I don’t know if these numbers are evidence that Meaningful Use is on the skids, but a 17 percent dropoff is certainly troubling. Clearly something must be done to reach out to providers who’ve climbed off the train.

Keith,
Interesting post on the topic. The real challenge in any of these discussions is “what is the purpose of meaningful use?” The problem I’ve always had is that everyone has made their own interpretation of what they thought meaningful use and the EHR incentive money is meant to accomplish. If there’s no goal for MU, then it’s hard to say if the failure is a good or a bad thing.

What might account for part of this trend is that hospitals/health care entities are now beginning to merge, and some are going under or likely to do so. Also, there seems to be an undercurrent of “this wasn’t really going to happen.”

In my opinion,it comes down to what are the executive management’s expectations for their EHR software? If the software vendor has communicated to them that they will automatically achieve attestation by using their solution, it is setting that healthcare organization up for failure. In the majority of cases (and most likely the reason for the high percentage of failure)is that hospital’s and healthcare systems alike do not have the ability to (in addition to their EHR) ensure proper compliance after the initial implementation, nor do they have the proper documentation available to support their claims for meaningful use. In the event of an audit by Figliozzi and Co., the hospital must have the proper supporting documentation so they can clearly support MU claims. The EHR is only one piece of the equation, and in most cases does not provide the correct resources to endure a MU audit.

Kip,
I think you’re partially missing the point of the drop out rate. What you say is true and we see that in healthcare. However, in this case they’ve successfully attested to MU and then they choose not to do it the next year. That’s quite different than someone who can’t attest the first time because of not having the ability to show proper compliance. In most of these cases they could have complied, but chose not to for some reason.

Thanks for the clarification on that John. While I do understand that they may have already initially attested for MU, the point I was trying to drive home (that you mention above) is that attestation isn’t a one time ordeal. I’m seeing other articles from providers wondering if the government is intentionally created the MU criteria to be so difficult that it is forcing doctors into ACO’s. While I personally don’t think that is the case, is it possible that the dropout rate we are discussing has more to do with maintaining that status for future payments as well? In the event of an audit, is the hospital able to pull together the resources and documentation to support their future claims for attestation? Or, is it such a difficult task for those 17% that they simply just dropped out? It may just a coincidence, but the dropout rate is right around the same rate of hospitals audited. While I agree, not every hospital audited is going to drop out and there are other circumstances that might cause them to do so. However, it would be interesting to see if there is a correlation with regard to audit/dropout rates and it’s future affect on an HC organization with regard to their use of EHRs.

[…] measures for 90 consecutive days for year 1 versus a full calendar year for year 2. In the article “Meaningful Use Dropout Rate At 17 Percent” published in HIT Consultant, Evan Steele, CEO of SRSsoft EHR and creator of EMR Straight Talk, […]